Objective This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma. Methods A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 wer...Objective This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma. Methods A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathological examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed. Results The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3 cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma （DLBCL）, and 3 patients were pathologically diagnosed with Burkitt＇s lymphoma. Up to 8 patients had CD4 cell counts below 200/μL, and 2 patients had a level of more than 200/μL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were not examined. Six patients underwent different chemotherapy and their prognoses were different. One patient with Burkitt＇s lymphoma alternatively took CODOXM and IVAC for 3 turns after VP chemotherapy; 1 patient with liver metastasis took R-CHOP 5 times, then changed therapy regimen to R-MINE and MINE. One patient with adrenal DLBCL took CHOP 6 times. Three patients with DLBCL took CHOP 1 or 2 times. Four patients gave up treatment. Various infections and side effects occurred, including bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAARI, and 4 did not. Six patients died, whereas 3 patients got improved; and 1 patient was discharged. Conclusions AIDS patients with malignant lymphoma had various clinical manifestations, were immunocompromised, and had multiple metastases when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional complications occurred. HAART failed to improve patient prognosis, and the overall prognosis was poor.展开更多
Background: Recent studies reported that patients with coronavirus disease-2019(COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase(ALT), aspar...Background: Recent studies reported that patients with coronavirus disease-2019(COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin(TBil) have been shown.Methods: This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group(n=79) and severe group(n=26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.Results: 56.2%(59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4%(96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range(ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group(P<0.05). The percentage of the patients with elevated both ALT and AST was 12.7%(10/79) in mild cases vs. 46.2%(12/26) in severe cases(P=0.001). 34.6%(9/26) severe group patients started to have abnormal ALT after admission, and 73.3%(77/105) of all patients had normal ALT before discharge.Conclusions: Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3×ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.展开更多
Objective The aim of the study was to evaluate the characteristics of HIV drug-genotypic resistance among patients taking first-line ARV regimens using polymerase chain reaction and sequencing,and guide to design opti...Objective The aim of the study was to evaluate the characteristics of HIV drug-genotypic resistance among patients taking first-line ARV regimens using polymerase chain reaction and sequencing,and guide to design optimal ARV regimens for these patients.Methods HIV reverse transcriptase-encoded gene was amplified with RT-PCR and amplified PCR products were aligned and comparatively analyzed with HIV resistance database to find drug-resistance mutations.Results Twenty-eight PCR products were amplified and sequenced successfully in 30 serum samples of recruited HIV-infected patients with virologic failure.The resistance rate was 96%,mutations in NRT region were found in 26 patients(93%),while mutations in NNRT region were found in 27 patients(96%).M184V was the most common mutation(86%),K65R was selected in 14%of recruited individuals and TAMs occurred in 50%of patients,which resulted in resistance to NRTIs.Y181C and V179D were the most common mutations in NNRTIs and prevalence was 43%(12/28)and 36%(10/28),respectively,which resulted in cross-resistance to NNRTIs due to low-genetic barrier.Conclusions Virologic failure may occur in long-term administration of first-line ARV regimens,and drugresistance mutations can be found in these patients,which resulted in resistance to first-line ARV regimens.We emphasized that HIV viral load assay and resistance assay were important tools to guide healthcare workers to design an optimal second-line ARV regimens for HAART-experienced individuals with virologic failure.展开更多
基金supported by a grant from the Major Scientific Projects of the National Eleventh Five-year Special Planning in Prevention and Treatment of Main Infectious Diseases, such as AIDS and Viral Hepatitis(No.2008ZX10001-006)
文摘Objective This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma. Methods A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathological examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed. Results The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3 cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma （DLBCL）, and 3 patients were pathologically diagnosed with Burkitt＇s lymphoma. Up to 8 patients had CD4 cell counts below 200/μL, and 2 patients had a level of more than 200/μL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were not examined. Six patients underwent different chemotherapy and their prognoses were different. One patient with Burkitt＇s lymphoma alternatively took CODOXM and IVAC for 3 turns after VP chemotherapy; 1 patient with liver metastasis took R-CHOP 5 times, then changed therapy regimen to R-MINE and MINE. One patient with adrenal DLBCL took CHOP 6 times. Three patients with DLBCL took CHOP 1 or 2 times. Four patients gave up treatment. Various infections and side effects occurred, including bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAARI, and 4 did not. Six patients died, whereas 3 patients got improved; and 1 patient was discharged. Conclusions AIDS patients with malignant lymphoma had various clinical manifestations, were immunocompromised, and had multiple metastases when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional complications occurred. HAART failed to improve patient prognosis, and the overall prognosis was poor.
基金supported by Scientific Research Projects of Beijing Ditan HospitalCapital Medical University+1 种基金Projects from Beijing Municipal Science and Technology Commission (D171100003117005)Digestive Medical Coordinated Development Center of Beijing Hospitals Authority (XXZ0402)。
文摘Background: Recent studies reported that patients with coronavirus disease-2019(COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin(TBil) have been shown.Methods: This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group(n=79) and severe group(n=26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.Results: 56.2%(59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4%(96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range(ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group(P<0.05). The percentage of the patients with elevated both ALT and AST was 12.7%(10/79) in mild cases vs. 46.2%(12/26) in severe cases(P=0.001). 34.6%(9/26) severe group patients started to have abnormal ALT after admission, and 73.3%(77/105) of all patients had normal ALT before discharge.Conclusions: Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3×ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.
基金The Twelve-fifth Key Project: The Study of Construction of Representative areas for Prevention and Therapy of Fatal Infectious Diseases such AIDS & Viral Hepatitis in Chaoyang District Beijing (2012ZX10004-904)Beijing Natural Science Fund: The evaluation of association between polymorphism of leptin or adiponectin and NAFLD complicated with AIDS (7112065)
文摘Objective The aim of the study was to evaluate the characteristics of HIV drug-genotypic resistance among patients taking first-line ARV regimens using polymerase chain reaction and sequencing,and guide to design optimal ARV regimens for these patients.Methods HIV reverse transcriptase-encoded gene was amplified with RT-PCR and amplified PCR products were aligned and comparatively analyzed with HIV resistance database to find drug-resistance mutations.Results Twenty-eight PCR products were amplified and sequenced successfully in 30 serum samples of recruited HIV-infected patients with virologic failure.The resistance rate was 96%,mutations in NRT region were found in 26 patients(93%),while mutations in NNRT region were found in 27 patients(96%).M184V was the most common mutation(86%),K65R was selected in 14%of recruited individuals and TAMs occurred in 50%of patients,which resulted in resistance to NRTIs.Y181C and V179D were the most common mutations in NNRTIs and prevalence was 43%(12/28)and 36%(10/28),respectively,which resulted in cross-resistance to NNRTIs due to low-genetic barrier.Conclusions Virologic failure may occur in long-term administration of first-line ARV regimens,and drugresistance mutations can be found in these patients,which resulted in resistance to first-line ARV regimens.We emphasized that HIV viral load assay and resistance assay were important tools to guide healthcare workers to design an optimal second-line ARV regimens for HAART-experienced individuals with virologic failure.
